Clinical characteristics, management strategies, and outcomes of pediatric immune thrombocytopenic purpura: a five-year single-center experience

Ö.S. Kaya, E.G. Kazancı, D. Güven, B. Orhaner

Department of Pediatrics, University of Health and Sciences, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey. deniz.guven06@hotmail.com

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• Pediatrics

OBJECTIVE: Immune thrombocytopenia (ITP), which is caused by immune-mediated platelet loss, is the most common cause of acquired thrombocytopenia in pediatric patients. In addition to evaluating treatment approaches and outcomes within a single-center cohort, this study aimed to evaluate the clinical and laboratory characteristics of juvenile ITP.

MATERIALS AND METHODS: Out of 296 patients with thrombocytopenia, 135 children (ages 0-18) with acute ITP were included in this retrospective analysis. We reviewed clinical observations, laboratory results, therapeutic modalities, length of hospital stay, demographic data, and treatment outcomes.

RESULTS: Out of 296 patients, 161 (54.4%) had secondary thrombocytopenia, and 135 (45.6%) had ITP. 51.1% of the population was female, and the average age was 5.5±3.97 years. The most common symptoms were petechiae (40%) and ecchymosis (46.7%). 83.7% of patients received intravenous immunoglobulin (IVIG), resulting in a 91.2% response rate after a single dose. 14.1% of patients received corticosteroids, and most of them achieved platelet counts ≥30,000/mm³. In 15.6% of cases, bone marrow aspiration was performed prior to the start of steroid treatment. Splenectomy was required in 0.7% of cases, and rituximab in 1.5%. There was no discernible variation in the treatment response between the modalities (p=0.34). Secondary thrombocytopenia (n=161) was primarily caused by infection (64.5%), with Epstein-Barr virus being found in 3.7% of cases.

CONCLUSIONS: IVIG promoted rapid platelet recovery with high responder rates. Overall, the results were favorable, and there were no discernible differences between the treatment plans.